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Keywords = clinical incivility

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21 pages, 403 KiB  
Review
Interventions to Address Clinical Incivility in Nursing: A Systematic Review
by Anne Lama, Henrietta Nwamu and Younglee Kim
Nurs. Rep. 2025, 15(6), 199; https://doi.org/10.3390/nursrep15060199 - 3 Jun 2025
Cited by 1 | Viewed by 1391
Abstract
Background/Objectives: Clinical incivility is a persistent issue in nursing education and practice, with negative impacts on students, educators, and clinicians. Uncivil behaviors—such as belittling, exclusion, and dismissiveness—compromise communication, teamwork, and patient safety. Although various interventions have been implemented, their effectiveness remains inconsistent. This [...] Read more.
Background/Objectives: Clinical incivility is a persistent issue in nursing education and practice, with negative impacts on students, educators, and clinicians. Uncivil behaviors—such as belittling, exclusion, and dismissiveness—compromise communication, teamwork, and patient safety. Although various interventions have been implemented, their effectiveness remains inconsistent. This systematic review aimed to evaluate the effectiveness of interventions addressing clinical incivility in nursing and to identify common trends, gaps, and implications for future practice and research. Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, Web of Science, and EBSCOhost (CINAHL) for peer-reviewed empirical studies published between 2014 and 2024. Search terms included “clinical incivility” and (“intervention” or “program” or “training”) and “nursing”. Studies were eligible if they evaluated interventions aimed at reducing incivility among nursing students, faculty, or practicing nurses. Seventeen studies met the inclusion criteria and were analyzed for intervention types, target populations, delivery methods, and outcomes. Results: The review identified five main intervention types: educational modules (n = 9), cognitive rehearsal (n = 5), simulation and role-play (n = 5), team-based strategies (n = 3), and feedback/communication strategies (n = 2). Many studies used multiple strategies. Fourteen studies reported positive outcomes such as improved awareness, communication, and self-efficacy. Eight studies demonstrated statistically significant reductions in perceived incivility, particularly those with simulation-based, multi-session, or institutionally supported formats. Three studies showed limited or mixed results due to insufficient follow-up or lack of leadership engagement. Conclusions: Experiential and multi-component interventions appear effective in reducing clinical incivility. Long-term success requires leadership engagement, institutional support, and integration into ongoing professional development. Full article
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14 pages, 258 KiB  
Article
Building Confidence, Diminishing Stress: A Clinical Incivility Management Initiative for Nursing Students
by Younglee Kim, Yeon Sook Kim, Henrietta Nwamu and Anne Lama
Nurs. Rep. 2024, 14(3), 2485-2498; https://doi.org/10.3390/nursrep14030183 - 19 Sep 2024
Cited by 3 | Viewed by 4634
Abstract
Objective: The aim of this study was to evaluate the effectiveness of an interactive program designed to reduce nursing students’ perceived stress and improve self-efficacy and readiness to professionally address incivility during clinical practice. Background: Incivility in clinical settings adversely impacts learners, educators, [...] Read more.
Objective: The aim of this study was to evaluate the effectiveness of an interactive program designed to reduce nursing students’ perceived stress and improve self-efficacy and readiness to professionally address incivility during clinical practice. Background: Incivility in clinical settings adversely impacts learners, educators, institutions, and healthcare systems, undermining safety and the teaching–learning process. Despite its increasing global prevalence, effective interventions remain largely unexplored. Methods: Our mixed-methods study, conducted from March to April 2024, involved senior baccalaureate pre-licensure nursing students (N = 35) from a California State University. The three-week, one-hour-per-week, interactive clinical incivility management program was developed through an extensive literature review. Pre- and post-intervention differences were assessed using a 10 min self-administered online survey that included the Uncivil Behavior in Clinical Nursing Education (UBCNE; 12 items), Perceived Stress Scale (PSS; 10 items), General Self-Efficacy Scale (GSE; 10 items), and a sample characteristics questionnaire (11 items). A one-hour face-to-face focus group (n = 11) then provided qualitative data on personal experiences of clinical incivility. Quantitative data were analyzed using SPSS version 27, while qualitative data were analyzed using Colaizzi’s method. Results: Clinical incivility prevalence was 71.4% (n = 25 out of 35). No statistically significant differences were found in UBCNE, PSS, and GSE scores between pre- and post-intervention. However, professional responses to clinical incivility significantly improved after the intervention (t = −12.907, p < 0.001). Four themes emerged from the qualitative data: (a) uncivil behaviors or language from nurses, (b) emotional discouragement and low self-confidence, (c) resource and personnel shortages at clinical sites for education, and (d) the necessity for interventions to manage clinical incivility. Conclusions: Nursing schools and clinical agencies should collaborate to establish monitoring systems, enhance communication, and implement evidence-based policies and interactive interventions to prevent and manage clinical incivility experienced by nursing students from clinical sites. Full article
16 pages, 263 KiB  
Article
Experiences with Negative Behavior and Incivility: Perspectives of Unlicensed Assistive Personnel and Registered Nurses
by Diana Layne, Christina Beall, William T. Bryant, Lynnette Morris and Heather Craven
Nurs. Rep. 2024, 14(3), 1706-1721; https://doi.org/10.3390/nursrep14030127 - 16 Jul 2024
Cited by 3 | Viewed by 2897
Abstract
Healthcare professionals experience negative behaviors such as incivility from various sources within the hospital environment. However, little is known regarding the experience of unlicensed assistive personnel with these behaviors. Using a cross-sectional survey design, the research team aimed to examine the presence, sources, [...] Read more.
Healthcare professionals experience negative behaviors such as incivility from various sources within the hospital environment. However, little is known regarding the experience of unlicensed assistive personnel with these behaviors. Using a cross-sectional survey design, the research team aimed to examine the presence, sources, and impact of negative behaviors among registered nurses and unlicensed assistive personnel within a US hospital. Descriptive and inferential statistics were used to analyze quantitative data, while thematic analysis was used to analyze the qualitative responses. A total of 309 participants completed the survey, and 135 participants responded to three qualitative questions. Most respondents identified inadequate staffing/resources to handle workload (87%) and job stress leading to loss of control over behavior as contributing factors to lateral/vertical aggression in the work environment (71%). Impacts of negative behavior on job performance were related to both personal well-being and the work environment. Demoralization was identified as a common consequence of negative behaviors for individuals and within the work environment. The results suggested that registered nurses, unlicensed assistive personnel, and nursing leadership may benefit from system-wide approaches addressing negative behaviors such as incivility within the clinical environment. Specifically, efforts and policies aimed at aiding clinicians in responding to negative behaviors could potentially improve the clinical environment. Full article
(This article belongs to the Special Issue Workplace Violence in Nursing and Midwifery)
13 pages, 473 KiB  
Article
A Clinical Incivility Management Module for Nursing Students: A Quasi-Experimental Study
by Younglee Kim, Sook Young Kim, Eunhee Hong and Cheryl Brandt
Healthcare 2023, 11(19), 2680; https://doi.org/10.3390/healthcare11192680 - 3 Oct 2023
Cited by 3 | Viewed by 3113
Abstract
Background: Incivility experienced by pre-licensure nursing students in clinical settings continues to grow. Interventions for clinical incivility to nursing students are needed. Our study aimed to examine the effects of a piloted two-hour interactive incivility management module on nursing students’ perceived stress and [...] Read more.
Background: Incivility experienced by pre-licensure nursing students in clinical settings continues to grow. Interventions for clinical incivility to nursing students are needed. Our study aimed to examine the effects of a piloted two-hour interactive incivility management module on nursing students’ perceived stress and general self-efficacy levels and preparedness for responding professionally to clinical incivility. Methods: A quasi-experimental post-test-only non-equivalent comparison design with control and experimental groups was used. Senior nursing students enrolled in a Bachelor of Science in Nursing program from a nursing college located in Seoul, South Korea, were recruited. The control group (n = 94) completed a self-administered online survey without the clinical incivility management module. The experimental group (n = 93) completed the same survey after receiving the clinical incivility management module. The two groups’ survey data were compared; qualitative data from the experimental group’s post-module debriefing session were also analyzed. Results: The prevalence of reported clinical incivility was 72.73% (n = 137 out of 187 participants). Clinical incivility experienced by the experimental group was significantly lower than that of the control group (z = −4.865, p < 0.001). However, there was no significant difference in stress levels and self-efficacy between the two groups. The mean score of the experimental group on preparedness for responding professionally to clinical incivility was statistically higher than the control group’s mean score (z = −2.850, p = 0.004). Conclusions: Interventions to prepare students for the experience of clinical incivility are useful; they can positively affect the students’ ability to respond professionally. Full article
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12 pages, 324 KiB  
Article
Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators
by Jennifer S. Mascaro, Patricia K. Palmer, Marcia J. Ash, Caroline Peacock, Cam Escoffery, George Grant and Charles L. Raison
Int. J. Environ. Res. Public Health 2021, 18(22), 11855; https://doi.org/10.3390/ijerph182211855 - 12 Nov 2021
Cited by 5 | Viewed by 3295
Abstract
While oncology clinical research coordinators (CRCs) experience a combination of factors that are thought to put them at increased risk for burnout, very little research has been conducted to understand the risk factors associated with burnout among CRCs. We used a mixed-method approach, [...] Read more.
While oncology clinical research coordinators (CRCs) experience a combination of factors that are thought to put them at increased risk for burnout, very little research has been conducted to understand the risk factors associated with burnout among CRCs. We used a mixed-method approach, including self-report questionnaires to assess burnout and compassion satisfaction, as well as individual and interpersonal variables hypothesized to impact CRC well-being. We also conducted a focus group to gain a more nuanced understanding of coordinators’ experiences around burnout, teamwork, resilience, and incivility. Coordinators reported relatively moderate levels of burnout and compassion satisfaction. Resilience, sleep dysfunction, stress, and incivility experienced from patients/family were significant predictors of burnout. Resilience and incivility from patients/family were significant predictors of compassion satisfaction. Themes that emerged from the focus group included that burnout is triggered by feeling overwhelmed from the workload, which is buffered by what was described as a supportive work culture based in teamwork. This study identified variables at the individual and interpersonal level that are associated with burnout and compassion satisfaction among oncology CRCs. Addressing these variables is of critical importance given that oncology CRCs and team-based coordinator care are vital to the success of clinical trials. Full article
(This article belongs to the Special Issue Physical and Mental Health in the Workplace)
14 pages, 344 KiB  
Article
“You Need to Get Over the Difficulties and Stand Up Again”—A Qualitative Inquiry into Young Nurses’ Coping with Lateral Violence from the Feminist Perspective
by Aimei Mao, Hon Lon Tam, Pak Leng Cheong and Iat Kio Van
Int. J. Environ. Res. Public Health 2021, 18(13), 7167; https://doi.org/10.3390/ijerph18137167 - 4 Jul 2021
Cited by 10 | Viewed by 4274
Abstract
Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring [...] Read more.
Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility. Full article
(This article belongs to the Collection Nursing Research)
11 pages, 292 KiB  
Article
Cyberincivility Experience of Korean Clinical Nurses in the Workplace: A Qualitative Content Analysis
by Sang Suk Kim, Ho Jeong Song and Jung Jae Lee
Int. J. Environ. Res. Public Health 2020, 17(23), 9052; https://doi.org/10.3390/ijerph17239052 - 4 Dec 2020
Cited by 1 | Viewed by 2450
Abstract
Although clinical nurses use online platforms to acquire health-related information and communicate with other healthcare providers, there are increasing reports on their incivility exposure in cyberspace. However, an in-depth understanding of their cyberincivility experience is lacking. This study aimed to identify Korean clinical [...] Read more.
Although clinical nurses use online platforms to acquire health-related information and communicate with other healthcare providers, there are increasing reports on their incivility exposure in cyberspace. However, an in-depth understanding of their cyberincivility experience is lacking. This study aimed to identify Korean clinical nurses’ perception and experience of cyberincivility. A qualitative study was conducted. Twenty clinical nurses from seven private and public hospitals in the Seoul metropolitan area were recruited using purposive sampling. Individual semi-structured interviews were conducted with the nurses from June to September 2019. Conventional content analysis was applied for the interview data analysis. Clinical nurses perceived cyberincivility as disrespectful and condemning behavior as users hide under the shield of anonymity to persecute others without fear of retribution. Four themes regarding participants’ cyberincivility experience emerged: unprofessional behavior, hierarchical communication, lack of respect and morality, and forming an inefficient work environment. The results of this study provide an understanding regarding clinical nurses’ experience of cyberincivility that goes beyond that of previous studies, which mainly focused on students. These results could increase awareness of cyberincivility among clinical nurses, and provide key information for the design of cybercivility educational programs and guidelines to curb cyberincivility, nurture professional online communication, and consequently improve quality of care. Full article
(This article belongs to the Section Nursing)
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